Normal Post-partal Period Flashcards
In the postpartum period the Temperature may raise to what and when ?
100.4 during the first 4 hours
What is the BP like in the postpartum period ?
Stable
A HR of what is common in the 6 to 10 days after a delivery ?
HR of 50 to 70 bpm
Tachycardia + Postpartum = ?
Think Hemorrhage
pregnancy = increased blood volume, so… should see less after birth
How are the Breasts postpartum ?
Soft for 2 to 3 days, then the dreaded engorgement occurs
What is the Abdomen like Postpartum ?
Soft/loose
Is hunger common in the mom in the postpartum period ?
Yes!
Can’t eat when in labor
What does FB stand for ?
Finger breadths
What is the fungus like in the postpartum period ?
The funds is midline 2 to 3 finger breadths (FB) below the umbilicus
Where is the fundus located a few hours after birth ?
It rises to the level of the umbilicus or to one FB above
What do you want the funds to be in the postpartum period ?
Firm***
What is the first thing you do if the Funds is boggy ?
massage the funds until it is firm and then check for bladder distention
In the Postpartum period, bladder distention is suspected when ?
When the uterus is above the expected level or is not in the midline
(usually moved to the right)
A distended bladder will not do what ? And increases the chance of what ?
Will not allow the uterus to contract normally
Which increases the chance of hemorrhage
Fundal height will decrease how ?
Will decent one finger breadth/day
What is the proper term used the the funds descends and the uterus returns to it’s pre-pregnancy size ?
Involution
if doesn’t happen, worry about hemorrhage
Afterpains are common when ? And will continue if what ?
For the first 2 to 3 days & will continue to be common if the mother chooses to breastfeed
(every time mom nurses, the body releases oxytocin which makes the uterus contract)
Rubra Lochia is seen when ? and is what color ?
3 to 4 days & is dark red
Serosa Lochia is seen when ? And is what color ?
4 to 10 days & is Pinkish brown
Alba Lochia is seen when ? And is what color ?
10 to 28 days (can be as long as 6 weeks) & is Whiteish yellow
You can have ________ Lochia up to 6 weeks ?
Alba
Clots are okay postpartum as long as they are what ?
No larger than a Nickel
Urine output:
After delivery, you should diuresis the excess fluid around when ?
Around 24 hours
Is Dehydration possible postpartum ?
Yes
Why should the legs be inspected so closely following delivery ?
For a DVT
What are Tx’s for Perineal Care in the postpartum period ?
- Intermittent ice packs for the first 24 hours (to decrease edema)
- Warm water rinses
- Sitz baths 2 to 4 times/day
- Anesthetic sprays
- Change pads frequently
- Teach to report foul smell and any loch changes
What is the Peripad rule in the Postpartum period ?
We do not want the client to saturate more than one peripad/hour
Bonding with parents in the Postpartum period develops what ?
Trust in the infant
In the infant, trust is not only an emotional need, but also a what ?
Physiologic need (Maslow’s)
How does the Newborn benefit physiologically from bonding ?
Skin to skin contact
- stabilizes HR
- improves O2 stats
- regulates the infants temp
- Conserves calories
- Breasts can change in temp to warm or cool the infant
True or False:
The moms breast can change in temperature to warm or cool the infant ?
True
Skin to skin contact is called what ?
Kangaroo care
What is Kangaroo care & how is it done ?
- Mom or dad places baby “skin to skin” on their chest
- The baby is wrapped inside the parent’s shirt or covered with a blanket and held for 1 hour at least 3 times a week
(focus on premies, but now standard for all)
How should the mom cleanse the breast after each feeding ?
With warm water & let air dry
Should moms use a Support bra postpartum for Breast care ?
Yes
can postpartum moms use ointment for breast soreness ?
Yes
Breastfeeding moms should do what postpartum in relation to Breast care ?
Express some colostrum and let it dry
Breast pads can be used Postpartum to do what ?
Absorb moisture
What does the mother need to initiate ASAP after giving birth ?
Need to initiate breastfeeding ASAP after birth & alternate breasts
If breastfeeding is interrupted, the mom can do what ?
Pump
Moms should increase their caloric intake by what postpartum ?
By 500 calories/day
The postpartum mother should have how much fluid/milk intake a day ?
Eight to ten 8 ounce glasses of fluid a day
What is the goal of non-breastfeeding mothers ?
To decrease engorgement
What are ways that Engorgement can be decreased in postpartum non-breastfeeding mothers ?
- Ice packs
- Breast binders (or ace wraps)
- Chilled cabbage leaves
- No stimulation of the breasts
Why are chilled Cabbage leaves a Tx for decreasing engorgement in non-breastfeeding mothers ?
B/c chilled cabbage leaves decrease inflammation and decrease engorgement
What are postpartum infections ?
Infections within 10 days after birth
E.coli, beta hemolytic strep
What do you want to teach to moms to reduce postpartum infections after birth ?
Proper hygiene (front and back cleansing)
For postpartum infections what do you usually get ?
Usually get cultures and Antibiotics
What is early postpartum hemorrhage defined as ?
More than 500mL of blood lost in the first 24 hours accompanied by a 10% drop from admission hematocrit
(you must have both to be true! (dual definition) )
What is late postpartum hemorrhage defined as ?
After 24 hours and up to 6 weeks postpartum
What are causes of Postpartum Hemorrhage ?
- Uterine atony (no tone = uterus will bleed)
- Lacerations
- Retained fragments and forceps delivery
What can cause Uterine atony ?
A full bladder
NCLEX TIP:
If get a OB question & don’t know the answer…. Pick Hemorrhage!!
What are Medications used to Halt Excessive Postpartum Hemorrhage ?
- Oxytocin (Pitocin)
- Methylergonovine maleate (Methergine)
- Carboprost tromethamine (Hemabate)
- Misoprostol (cytotec)
What can Mastitis be caused by ?
Poor hygiene or not feeding properly
What is the major bacteria with Mastitis ?
Staphylococcus
When does Mastitis usually occur ?
Around 2 to 4 weeks
What are the signs and symptoms of Mastitis ?
- Rapid onset of fever and chills
- The breast will be swollen, hard, and tender to touch
- Malaise
What is the Treatment for Mastitis ?
- Bed rest
- Support bra
- Binding and chilled cabbage leaves
(are only to be used if breastfeeding is being discontinued permanently) - Initiate breastfeeding frequently or pump (if going to continue breastfeeding)
- Penicillin (PCN)
- Pain medications (depends on what it is and when you take it)
- Heat (will cause breast to leak)
- Feed baby frequently
- Always offer the affected breast first
How should Penicillin be taken for the Tx of Mastitis ?
Feed baby then take it
What is the drug of choice for Mastitis ?
Penicillin
What may be given alternatively in a mom with Mastitis who is allergic to penicillin ?
Eythromyacin
